Tools used by the NHS to predict heart attack or stroke risk could also estimate cancer risk, a study from University College London (UCL) suggests. Researchers found that four common cardiovascular risk calculators performed as well as specialist cancer calculators at predicting bowel, prostate, and breast cancer over 10 years.
Study finds dual potential for existing tools
Hospitals and GPs currently use risk calculators that generate estimates based on factors including age, body mass index, and smoking status. The UCL team tested four models commonly used to assess cardiovascular risk over a decade. One tool examined was the QRISK3 model, which is used in England as part of the NHS Health Check for adults aged 40 to 74.
Lead author Dr Sam Quill, a PhD student at the UCL Institute of Cardiovascular Science, said: “We currently offer statins to people at higher risk of heart disease using the QRISK3 tool. Our study suggests the risk of certain cancers could be estimated at the same time. Detecting cancer early through screening is important and is what health systems currently focus on, but there is also more we could do to prevent cancer from developing in the first place.”
Shared risk factors link diseases
Cancer and cardiovascular disease together account for half of all deaths worldwide. They share many common risk factors, including obesity, physical inactivity, and poor diets. Specialist cancer risk calculators are available but, writing in the European Journal of Cancer, the researchers said they are “not frequently used in practice.” Being able to estimate risk for both conditions using the same tool could make it easier for medics to provide personalised prevention advice.
The study tested the tools for cancer using health data from people aged 40 to 84. They estimated overall percentage risk of cancer occurring over 10 years, as well as specific cancers over the same period. Age and sex were found to be the most influential risk factors, followed by smoking status and high blood pressure. The researchers noted that high blood pressure may not cause cancer directly but could be linked to other factors such as physical inactivity and excessive alcohol intake.
Next steps for implementation
Dr Quill added: “A single calculator estimating both cardiovascular disease and cancer risk could improve prevention of both conditions, as it would give clinicians and patients added reason to tackle shared and preventable risk factors. Rather than build new models from scratch, we repurposed established cardiovascular models to also consider cancer risk, and successfully validated them against models developed specifically for cancer prediction. There's still more to do before these models could be used in the NHS or elsewhere. Next steps would include exploring the role of these models in cancer prevention alongside public health interventions that are aimed at everyone, such as removing barriers to physical activity and healthy eating, and reducing exposure to tobacco and alcohol. Then we can understand which approach and which interventions work best for preventing cancer.”
Dr Sowmiya Moorthie, senior strategic evidence manager at Cancer Research UK, said: “Clinicians are already using cancer-specific risk calculators, especially for people with symptoms. They are also being trialled in some cancers, such as bowel and breast cancer, to help with screening — and we hope they will play a bigger role in earlier diagnosis in the future. If people are concerned about their risk of cancer, there are proven steps to help reduce it, including not smoking, keeping a healthy weight, and cutting down on alcohol.”
